Cases of RSV are rising in New Jersey, a year after the respiratory virus filled children’s hospitals across the state.
Though doctors are witnessing a growing number of respiratory syncytial virus patients, they are not seeing an avalanche of cases like last fall. That could change, however, as the weather gets colder.
So experts are touting a new RSV immunization for infants they consider a game-changer for reducing hospitalizations. But “unprecedented demand” has led to scant supplies after the busy 2022 cold and flu season.
Supplies are so limited that the Centers for Disease Control and Prevention issued an alert Monday advising pediatricians to prioritize nirsevimab — sold under the brand name Beyfortus — for infants most at risk. In other words, they’re rationing the new drug.
“I don’t think (the rise in cases) is as dramatic as we saw, say, last year,” said Stephanie Silvera, an infectious disease expert and professor at Montclair State University. “And I think what we’re probably falling back into is that more pre-pandemic wave of the expected number of cases and really following a more typical timeline.”
Last fall, the state saw a 35% spike in RSV cases, but New Jersey was still feeling the effects of the COVID-19 pandemic.
“Because of the time during the pandemic and kids not necessarily getting exposed to RSV, we saw a pretty significant uptick in volume earlier in the year,” said Dr. Harpreet Pall, chair of pediatrics at Hackensack Meridian School of Medicine and chair of the health system’s K. Hovnanian Children’s Hospital.
“This year, it seems to be milder.”
Still, RSV — a virus that typically causes mild, cold-like symptoms — can be severe, especially for babies, older adults and the immunocompromised. The virus is the leading cause of childhood illness and hospitalization in infants, according to the CDC.
Pall was hopeful Beyfortus — Sanofi’s monoclonal antibody drug — will dramatically reduce the number of cases. It was approved in July by the Food and Drug Administration.
“This is really a potential game-changer for RSV and kids, and also potentially for adults as well because now there’s going to be multiple vaccines and therapeutics that will be available,” he said.
Two RSV vaccines for adults 60 and older were approved earlier this year (60,000 to 160,000 older adults in America are hospitalized every year with RSV, and 6,000 to 10,000 die from it, according to the CDC).
Another RSV vaccine — palivizumab or Synagis — has long been available, but was approved only for children predisposed to severe diseases. Now, every kid 8 months and older can receive Beyfortus — provided it’s available.
More than 90% of infants are covered for the drug under health insurance plans as of Oct. 1, Sanofi has said.
The danger for kids is developing an RSV infection in the lower airway that can cause bronchiolitis, according to Pall.
“And that’s one of the most common reasons for (hospital) admission for kids,” he said.
Nirsevimab is a different kind of immunization. In fact, it’s technically not a vaccine. It’s a monoclonal antibody treatment, which differs from a traditional shot that causes the body to generate antibodies. With monoclonal antibody treatments, “you’re already getting the antibodies, (so) you don’t need time for the body to generate them,” Pall said.
“In some of the research that’s been done, this seems to prevent ... (hospital) admission by about 75% to 80%, which is very significant,” Pall said.
“That would be a game-changer over the next decade in children’s health because that really drives a lot of bed need and medical need in kids of this age,” he added.
And, unlike Synagis, a single shot can last about five months, studies have found. In other words, it can protect kids for an entire respiratory season, according to Pall.
Kids who are slightly older (say closer to 2 years old) and who have a predisposing condition — such as heart disease, lung disease or immunosuppression — can receive a second shot if needed.
“It’s a discussion that I would certainly suggest that all parents have with their primary care pediatrician to see how to go about doing this for this coming season,” Pall said.
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Spencer Kent may be reached at skent@njadvancemedia.com.
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